ABSTRACT
Objectives: The goals of this study are to examine factors associated with completed screening for suicide risk in the emergency department, and to examine clinical patterns of risk for suicide in children with physical health and mental health chief complaints in universal screening in the emergency department. Method(s): Of the 18,903 emergency department encounters between December 2019 and April 2022, there were 16,722 (88%) encounters that included results for the Ask Suicide-Screening Questions (ASQ) Toolkit. The chief complaints for the encounters were coded based on categories identified through central nervous system (CNS) involvement or conditions known to be associated with mental health risk with questions reviewed. ASQ results were coded as at risk if any question was answered with "yes." Factors associated with completed screening were entered into a binary regression. chi2 analyses were used to examine the associations between categorical variables. Result(s): Of the 18,903 ED encounters, 88.5% included a completed ASQ. Overall, 1924 (10.2%) encounters had positive ASQ results. Among encounters for non-mental health chief complaints, 8.9% were positive. Only 37.3% of the positive ASQ results were associated with mental health-specific chief complaints. Compared to general physical chief complaints, COVID-19-related concerns had lower rates of positive ASQ and interpersonal trauma, reproductive health, altered mental status, accidental and unspecified ingestions, and specific mental health symptoms (p <.01). In a regression including demographic factors and clinical factors, young age, White race, gender (girls), and chief complaint of interpersonal trauma, ingestion, or mental health symptom contributed to variance in ASQ (Nagelkerke's R2 =.339). Conclusion(s): The majority of positive screens for symptoms of suicide are associated with physical health chief complaints, with specific chief complaints having elevated rates of suicidal symptoms. Universal screening identifies these patients, and targeted interventions may be valuable for youth with the highest-risk chief complaints. S, TREAT, RF Copyright © 2022